Online Application Form

Select Title (required)


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Membership Type (required)

Payment Method (required)

Declaration

I certify that the above information is true and correct to the best of my knowledge.
I understand that membership is voluntary and at my own risk.
I agree to abide by the rules and constitution of the club.
I agree to the information I have provided being stored on the club database, shared with other club members and for membership purposes.

Privacy Notice

Declaration

By ticking this box, I confirm I have read and consent to the above Declaration and Privacy Notice

Once the Form is completed and sent, please complete payment via either;

PayPal by clicking “Buy Now” button below. (You do not need a PayPal account, you can pay via PayPal using a credit or debit card).



  Use this button for First Claim Membership


 Use this button for Second Claim Membership

Bank Transfer. Details are below. (Please make sure you add your name as a reference so we know who the payment is to be credited for). 

Electronic Payment Details

Account Name: Kippax Harriers

Sort Code: 40-39-21

Account No: 01101536

If you would like to pay by Cash or Cheque please arrange this with the Membership Secretary when you are contacted.

Finally, If you would like to order a Kippax Harriers Running Vest (or any other Kippax Harriers Kit) please head on over to the Kit section here to order.